Breast

Mastectomy (Modified Radical) with Axillary Lymph Node Clearance

MASTECTOMY (MODIFIED RADICAL) WITH AXILLARY LYMPH NODE CLEARANCE

Indication: Invasive breast carcinoma requiring mastectomy with known or confirmed axillary lymph node involvement (positive sentinel node, clinically node-positive axilla) requiring formal axillary clearance. Retains the pectoralis major muscle (preserving shoulder function) — distinguishing it from Halsted's radical mastectomy.

Patient Position: Supine, arm extended at 90° on arm board.

Anaesthesia: General.

Prophylactic Antibiotics: Per local protocol.

Procedure:
1. Mastectomy performed as described for simple mastectomy (skin flaps raised, breast removed off pectoral fascia).
2. Axillary clearance (Level I–III dissection):
   a. Axillary fat pad dissected from the chest wall and axillary vein inferiorly.